Atrial fibrillation

Atrial fibrillation is a fast, erratic heart rhythm that starts in your heart’s upper chambers. Commonly called AFib or AF, this type of arrhythmia increases your risk for strokes and heart problems. At Atrium Health Floyd and Harbin Clinic, our heart specialists offer care that helps get your heart beating in a healthy pattern.

What is atrial fibrillation?

AF is the most common type of heart rhythm problem, or arrhythmia. It occurs when the upper heart chambers (atria) contract in a fast, irregular pattern. As a result, your heart can’t pump blood into the lower chambers (ventricles) as it should. Your ventricles may also have fast, erratic contractions.

A resting heart typically beats 60 to 100 times per minute. With AF, your heart may beat more than 150 times per minute.

Causes of atrial fibrillation

Damage to your heart’s electrical system causes AF. This damage causes electrical signals to travel through your heart in a rapid and chaotic manner.

Several health conditions can cause heart damage that leads to AF, including:

• Chronic obstructive pulmonary disorder (COPD)
• Congenital or structural heart defect
• Coronary heart disease, heart valve disease, or heart failure
• Diabetes
• High blood pressure (hypertension)
• Obesity
• Pericarditis
• Sick sinus syndrome
• Sleep apnea
• Thyroid disease

Atrial fibrillation symptoms

AF may not cause symptoms, or symptoms may come and go. Heart palpitations are the most common sign. Your heart may feel like it’s skipping a beat, fluttering, racing or pounding.

Other symptoms of AF may include:

• Chest pain (angina)
• Dizziness, lightheadedness or fainting
• Extreme fatigue
• Trouble breathing, especially during physical activity or when lying down

Atrial fibrillation types

Types of AF are based on how often the arrhythmia occurs and how it responds to treatment. Each type of AF can worsen or progress to the next type, especially without proper treatment.

Types of AF include:

• Paroxysmal AF, which causes a brief arrhythmia that usually goes away in 24 hours (but can last for up to a week). Arrhythmia episodes may come and go. You might not need treatment if symptoms go away.
• Persistent AF, which lasts for at least seven days in a row. The arrhythmia may eventually go away, but you’ll probably still need medications or other treatments to regulate your heart rhythm.
• Long-term persistent AF, which lasts for more than 12 months. This type requires more aggressive treatments, such as cardiac ablation or pacemakers, to get your heart into a healthy rhythm.
• Permanent AF, which doesn’t go away even with aggressive treatments. Medications can help manage your heart rate and prevent blood clots.

Atrial fibrillation diagnosis

Your health care provider will conduct a physical exam, which includes checking your pulse and blood pressure as well as listening to your heartbeat. They’ll also ask about your symptoms and medical history.

The most common test used to diagnose AF is an electrocardiogram (ECG/EKG). This test records your heart’s electrical activity. You may also get other tests, including:

• Blood tests to measure potassium and hormones
• Electrophysiology (EP) study to provide more details about your heart’s electrical activity
• Heart imaging tests, such as an echocardiogram, MRI or chest X-rays, to check heart function and structures
• Heart monitors, such as a Holter monitor or implantable loop recorder, to record your heart rhythm while you engage in daily activities
• Stress test to see how your heart rhythm changes during exertion

Atrial fibrillation risk factors

Your chances of developing AF increase as you get older. Other factors may also increase your risk, including:

• Addiction to alcohol, tobacco or other drug (substance use disorder)
• Anxiety disorder, especially panic disorder
• Family history of arrhythmia
• High-dose steroid therapy
• Stressful situations

Complications of atrial fibrillation

Without proper treatment, AF increases your risk of serious health complications. Complications can include:

• Blood clots that cause strokes
• Heart attack
• Heart failure

Atrial fibrillation prevention

These actions may help lower your chances of developing AF:

• Cut back on caffeine and alcohol.
• Find healthy ways to ease stress.
• Maintain a healthy weight through exercise and a nutritious diet.
• Manage conditions like anxiety and high blood pressure.
• Seek help to quit smoking or using other substances.